Your Birthday (00/00/0000)
Pets (Names and Types)
Address
City
State
Zip Code
Preferred Contact Number *
Preferred Email Address *
How did you hear about Savor? *
If you Googled us, what were the keywords you used?
Please check the boxes of the items that
you like only and place notes in the comment section.
Beef (steak/roasts/ground round) Steak cooked
Pork (chops/roasts/ribs/bacon/ham/ground)
Lamb (chops/stew/ground/roasts)
Meatloaf
Bison
Comments (Meats)
Chicken (breasts/thighs/ground, etc.)
Turkey (breasts/smoked/ground, etc.)
Chicken or turkey meatloaf
Comments (Poultry)
Fish (bass, yellowtail, orange roughy, salmon, snapper, etc.)
Shrimp
Scallops
Crab
Lobster
Comments (Fish/Shellfish)
Fresh Green (choice of greens/lettuces, such as Romaine, red leaf, bibb, mixture, spinach, etc.)
Fruit in your salad
Salads as a main dish
Comments (Salads)
SALAD DRESSINGS (List other salad dressings in the comments)
Ranch
Vinaigrette (any)
Comments (Salad Dressing)
Creamed
If you checked creamed, name type(s)
With meat/poultry?
Soups/Stews as a main dish?
Comments (Soups/Stews)
VEGETABLES (List vegetables you will not eat in the comments)
Green (peas, green beans, spinach, asparagus, peppers, cabbage, pea pods, celery, brussel sprouts, mustard greens/greens, broccoli, zucchini, avocadoes, poblanos, okra, kale, swiss chard)
Yellow (corn, wax beans, squash, peppers)
Red (pimento, red cabbage, beets, tomatoes, peppers, sweet potatoes/yams, carrots)
White (cauliflower, potatoes, parsnips, water chestnuts, bamboo shoots, bean sprouts, onions, mushrooms, leeks)
Beans (black, ranch-style, pinto, kidney, lima, white, pink, black-eyed peas, split peas)
Capers, black olives, green olives, coconut, artichokes, eggplant
Comments (Vegetables)
Rice (brown, white, wild, pilaf)
Couscous
Quinoa
Farro
Cornbread
Muffins
Pancakes / Waffles
Tortillas (corn, white or wheat)
Comments (Grains and Breads)
SEASONINGS (List seasonings you will not eat in the comments)
Oregano, sage, rosemary, tarragon, fennel, cumin, cilantro, paprika, parsley, celery, chili powder, curry
Fresh garlic, parsley
Pepper - white, black or red
Salt - Kosher (food is prepared very low in salt so that you may season to taste)
Comments (Seasonings)
Butter
Olive Oil and other healthy oils (sesame, walnut, pecan, avocado, truffle, etc.)
Comments (Fats/Oils)
MILK AND MILK PRODUCTS
(List any cheeses you do not like in the comments)
Cheeses (parmesan, cheddar, Swiss, muenster, fontina, blue, feta and goat etc.)
Milk (skim, 1%, 2%, whole)
Yogurt
Sour Cream
Comments (Milk Products)
Whole
Yolks Only
Dried Fruits
Nuts (pecans, peanuts, walnuts, almonds, cashews, Brazil, etc.)
Pizza
Comments (Eggs and Other)
Fruits disliked
List any known food allergies
Spicy foods - bland/mild/moderate/very hot
Do you have any favorite recipes that I can prepare for you?
Cuisines liked (Mexican/Curries/Italian, Home-style)
Favorite food/restaurants
Which meals (Breakfast, Lunch, Dinner, Snacks and Dessert)
Number days a week you/family will eat prepared food
Number of servings for each meal
Portion Control (Yes or No)
Service Frequency (weekly, bi weekly, bi monthly, monthly)
Sides with service (1 side with each entree or 2 with each entree
Organic or Non-organic groceries
Comments / Questions
Enter your initials to complete your questionnaire *
ALL DONE!
